DEPARTMENT OF INSURANCE
Affiliations
NameSimon, Jackson WallerDOIID1061886NAIC NPN19324124
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentHealth4/29/2024 10/31/2024
ActiveResidentAgentVariable Life and Variable Annuities12/18/2019 10/31/2024
ActiveResidentAgentLife12/18/2019 10/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent08/15/202410/31/2024   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAmerican General Life Insurance Company301585Agent - Life8/14/2024 
ActiveFidelity & Guaranty Life Insurance Company301359Agent - Life7/22/2024 
ActiveForethought Life Insurance Company301407Agent - Life7/7/2022 
ActiveForethought Life Insurance Company301407Agent - Variable Life and Variable Annuities7/7/2022 
ActiveIntegrity Life Insurance Company301687Agent - Life1/22/2024 
ActiveIntegrity Life Insurance Company301687Agent - Variable Life and Variable Annuities1/22/2024 
InactiveJackson National Life Insurance Company300486Agent - Life8/2/20228/17/2023
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities8/2/20228/17/2023
InactiveNationwide Life Insurance Company300495Agent - Life2/24/20229/18/2023
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities2/24/20229/18/2023
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life9/13/20229/18/2023
InactiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities9/13/20229/18/2023
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Life12/16/20228/16/2023
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Variable Life and Variable Annuities12/16/20228/16/2023
ActiveOceanview Life and Annuity Company301868Agent - Life12/24/2023 
InactivePacific Life Insurance Company301848Agent - Life12/12/202211/14/2023
InactivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities12/12/202211/14/2023
ActivePrincipal National Life Insurance Company301926Agent - Life3/6/2023 
ActivePruco Life Insurance Company300954Agent - Life5/9/2024 
ActivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities5/9/2024 
ActiveS.USA Life Insurance Company, Inc.301774Agent - Life7/25/2024 
ActiveStandard Insurance Company300185Agent - Health9/16/2024 
ActiveStandard Insurance Company300185Agent - Life9/16/2024 
InactiveSymetra Life Insurance Company301691Agent - Life2/21/20238/18/2023
InactiveSymetra Life Insurance Company301691Agent - Variable Life and Variable Annuities2/21/20238/18/2023
ActiveTalcott Resolution Life Insurance Company301759Agent - Life12/6/2022 
ActiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities12/6/2022 
ActiveUnited Life Insurance Company664766Agent - Life1/15/2024 
ActiveWestern-Southern Life Assurance Company301590Agent - Life1/22/2024 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveFifth Third Insurance Agency Inc399341Agent - Life12/5/2023 
ActiveFifth Third Insurance Agency Inc399341Agent - Variable Life and Variable Annuities12/5/2023 
InactiveMorgan Stanley Insurance Services Inc644934Agent - Life11/30/20228/17/2023
InactiveMorgan Stanley Insurance Services Inc644934Agent - Variable Life and Variable Annuities11/30/20228/17/2023

© Commonwealth of Kentucky. All rights reserved.